Treatment

Therapy is based on the stage of ovarian cancer, the patient’s age, plans to have children, and the patient’s overall health. Staging is critical, and ranges from early-stage disease to stage IV ovarian cancer, which means the cancer cells have already spread to nearby organs or distant sites in the body.

All patients' cases are discussed at Wilmot's gynecological oncology multidisciplinary tumor board — a conference that is attended by all different specialties required for your care.

Three treatments are primarily used for ovarian cancer: surgery, chemotherapy, and targeted therapy.

Surgery

This is the main treatment for ovarian cancer and usually involves a hysterectomy with the removal of all visible tumors. Wilmot gynecologic oncologists offer a number of surgical options at Highland Hospital, the hub for our gynecologic cancer team, and perform the largest number of minimally invasive surgeries in the region. Highland was the first hospital in the Finger Lakes region to have new technology that provides virtually scarless surgery. Our surgeons also use the daVinci robotic surgical system, which offers precision and enhanced 3D, high-definition views of the tumor and surrounding operative field. Surgical procedures include:

• Hysterectomy, during which the surgeon removes the uterus, cervix, fallopian tubes, and ovaries. This type of operation can be performed through an abdominal incision or laparoscopically with smaller instruments and special tools. There are pros and cons to each method, and it’s very important to thoroughly discuss the surgical options with your doctor and to understand the risks and benefits. Wilmot surgeons have expertise in both procedures.
• Bilateral salpingo-oophorectomy, in which the surgeon removes both fallopian tubes and both ovaries. It can be done at the same time as a hysterectomy. Removal of the ovaries causes premenopausal women to go into menopause.
• Omentectomy, in which the surgeon removes the omentum, the fatty tissue that covers the abdominal contents. Frequently ovarian cancer spreads to this tissue. During this procedure, surgeons sometimes wash the abdominal cavity with saline and send fluid from that area to a pathologist for analysis.
• Debulking, which is done if the cancer has spread widely throughout the abdomen. The surgeon will remove as much of the tumors as possible, and sometimes a small piece of the colon, bladder, or other nearby organs if the cancer has spread to that area. The aim of debulking surgery is to remove the tumors down to microscopic residual disease or to leave no tumor deposits that are larger than 1 cm.

Chemotherapy

Chemotherapy uses drugs or combinations of drugs — given intravenously or intraperitoneally — to destroy cancer cells. It can be given as part of the initial treatment, and again if ovarian cancer returns. Sometimes patients with advanced ovarian cancer get chemotherapy injected directly into the abdominal cavity through a thin tube. Giving chemo this way allows for the most concentrated dose and for quick absorption into the bloodstream, but the side effects can be severe.

Radiation 

Radiation therapy uses energy from radiation beams, radio isotopes, or charged particles to target tumors and to eradicate cancer cells.

Targeted therapy

These are newer drugs designed to target specific gene changes that result in ovarian cancer. They single out cancer cells and usually have less severe side effects compared to chemotherapy.  Some targeted therapies also harness the patient’s own immune system to fight the cancer. These types of treatment might be used in combination with other therapies for ovarian cancer. Olaparib (a drug known as a PARP inhibitor) is an example of a targeted therapy that attacks cancer caused by mutations in the BRCA1 and BRCA2 genes.

Side effects

Many standard cancer treatments cause side effects such as hair loss or fatigue, but not everyone experiences side effects the same way.

Wilmot's Cancer Control & Survivorship Program is one of the oldest and most highly regarded research programs in the country to investigate the management of side effects. 

The American Cancer Society also offers free online resources to help patients manage the side effects of their illness.